lidocaine/tetracaine (Rx)

Brand and Other Names:Synera, Pliaglis
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

lidocaine/tetracaine

transdermal patch

  • 70mg/70mg (Synera)

topical cream

  • 7%/7% (Pliaglis)
more...

Local Dermal Analgesia

Venipuncture or IV cannulation

  • Patch: Apply patch to intact skin 20-30 minutes prior to procedure

Superficial dermatological procedures (eg, excision, electrodessication, shave biopsy)

  • Patch: Apply patch to intact skin for 30 minutes prior to procedure

Topical cream

  • Indicated for use on intact skin in adults to provide topical local analgesia for superficial dermatological procedures (eg, dermal filler injection, pulsed dye laser therapy, facial laser resurfacing, laser-assisted tattoo removal)
  • Apply to intact skin 20-30 minutes prior to superficial dermatological procedures (eg, dermal filler injection, facial laser ablation)
  • Apply 60 minutes prior to procedures for laser-assisted tattoo removal or similar procedures
  • Dosage amount determined by surface area of treatment site (see prescribing information for details)

Dosing Considerations

Patch: Contains integrated, oxygen-activated heating component so do not cut patch or remove top cover due to risk of thermal injury; do not cover holes on top side of patch as it will not heat properly

Administration

Patch: Use immediately after opening pouch; only apply to intact skin; wash hands after handling patch

Dosage Forms & Strengths

lidocaine/tetracaine

transdermal patch

  • 70mg/70mg (Synera)
more...

Local Dermal Analgesia

Venipuncture or IV cannulation

  • <3 years: Safety and efficacy not established
  • >3 years (patch): Apply patch to intact skin 20-30 minutes prior to procedure

Superficial dermatological procedures (eg, excision, electrodessication, shave biopsy)

  • <3 years: Safety and efficacy not established
  • >3 years (patch): Apply patch to intact skin for 30 minutes prior to procedure
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Interactions

Interaction Checker

and lidocaine/tetracaine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Localized erythema (71%)

            Localized blanching (12%)

            Localized edema (12%)

            1-10%

            Other application site reactions (contact dermatitis, rash, skin discoloration) (<4%)

            <1%

            Rash

            Application site reactions

            Pruritus

            Dizziness

            Headache

            Pain

            N/V

            Contact dermatitis

            Infection

            Skin discoloration

            Somnolence

            Allergic reaction

            Blister

            Paresthesia

            Urticaria

            Vesiculobullous rash

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            Warnings

            Contraindications

            Hypersensitivity to drug, components or PABA

            Cautions

            Severe hepatic or pseudocholinesterase deficiency

            Do not use on broken skin or mucous membranes

            Use caution if applied for longer period than recommended

            Produces mild localized warming of skin to facilitate drug absorption

            Simultaneous/successive patches not recommended due to risk of serious adverse effects caused by increased systemic absorption

            Do not apply near eyes as loss of protective reflexes can permit corneal irritation and potential abrasion

            Severe hepatic or pseudocholinesterase deficiency due to increased risk of toxic plasma concentrations of lidocaine/tetracaine

            Lidocaine and prilocaine have been shown to inhibit viral and bacterial growth

            Integrated heating component contains iron; remove patch prior to MRI

            Instruct patient to avoid irritating or exposing treated area to extreme temperatures until complete sensation has returned

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: Lidocaine excreted in breast milk; tetracaine unknown; use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Amide-type local anesthetics stabilize neuronal membranes and prevent generation/conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold

            Absorption

            Positively correlated to degree of systemic absorption

            Peak plasma concentrations: 148-641 ng/mL (lidocaine)

            Distribution

            Vd (IV administration): 0.8-1.3 L/kg (lidocaine)

            Protein bound: 75% (lidocaine)

            Metabolism

            Unknown if metabolized in skin

            Systemic metabolism: hepatic (lidocaine); plasma esterases (tetracaine)

            Metabolites: ester- and amide-type local anesthetics

            Elimination

            t1/2 (IV administration): 1.8 hr (lidocaine)

            Excretion (IV administration): Urine (98%) [lidocaine]

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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